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Agency and overseas staff vital to ‘buy time’ until ‘boom and bust’ approach overturned

Mismatches between funding and staffing levels and repeated reorganisation have caused a “boom and bust approach” to the NHS frontline and will threaten the FYFV ambitions unless NHS providers use agency staff and overseas recruitment “to buy time” in the short term, the Health Foundation said in a scathing report today.

The report, ‘Staffing matters; funding counts’, examined the profile and features of the current NHS workforce, health labour market trends, international data and the specific pressure points in the English healthcare workforce – especially across nursing and general practice, the two areas facing particular shortages.

The foundation said that the cheaper, reactive and short-term solutions being deployed nationally and locally to tackle existing problems are just “quick fixes” and will only “put a sticking plaster on deep-seated and systematic problems”.

But it endorsed the use of temporary staff and international recruitment as a way to buy time until a more long-term and sustainable approach is rolled out.

It added that there should not be an overemphasis on new staff roles to the detriment of investing in current staff, arguing some new roles are necessary, but will not have a major impact without “significantly more” central support.

This echoes similar calls made during last month’s NHS Confederation conference by The Nuffield Trust’s Candace Imison, who said reskilling and upskilling existing staff was better than adding new employees.

Anita Charlesworth, director of research and economics at the Health Foundation, had already warned during the Confed conference that workforce issues were going to be the ‘make it or break it’ of the NHS in the coming years.

Charlesworth, who is one of the three authors of the report, added today: “Funding constraints and workforce shortages without a doubt present the greatest risks to the delivery of the FYFV – and the longer-term sustainability of our NHS. The current approach to workforce policy needs to be overhauled so that staffing and funding are treated as two sides of the same coin.

“The recent decision for the UK to leave the EU will create additional challenges – both in terms of finances and the ability to attract and retain valuable European staff. We urgently need a fully aligned and coordinated national approach to workforce policy and planning, underpinned by greater predictability on funding, to ensure the NHS can sustain high quality health care for the long term.”

According to the foundation, the answers to the six critical aspects of the profile and dynamics of the current health workforce are:

The president of the Royal College of Physicians, Professor Jane Dacre, said today’s report was “yet more evidence” that the health system is “underfunded, underdoctored and overstretched”, pointing to the “major shortages” of consultant physicians in some specialties.

“In one of our surveys, two in five physicians said that rota gaps are compromising patient care, and half reported having to find a workaround solution to prevent patient care being compromised,” she added.

“The situation needs to be addressed urgently – we need more doctors, other clinical staff and more medical school places if we are to meet the future needs of patients.”

The Health Foundation report comes as part of a double-blow to the NHS this morning, as leading think-tank The King’s Fund also published a major analysis of the health system’s growing 2016 deficit. The analysis, amongst other things, recommended that the government review its priorities for the NHS to ensure they can be delivered within the available resources.

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